CESTODE

MORPHOLOGY

MOT PREVENTION DIAGNOSIS TREATMENT INTESTINAL CESTODES

INTERMEDIATE HOST

CLINICAL COMPLICATION

Taenia Saginata (Beeftapeworm) (Cysticercus bovis) mucosa of wall of ileum

EGG

round in shape & bile stained. Has a thin egg shell. The radially striated embryophore made of keratin surrounds the hexacanth embryo or oncosphere with 3 pairs of hooklets. Cysticercus bovis

Cattle ( larval stage -Cysticercus bovis)

MOT consumption improperly cooked beef containing cyst

It contains a invaginated protoscolex with 4 suckers but no hooks. The cyst is filled with fluid & the outer wall has villi. ADULT

PREVENTION Treat infected individuals Prevent contamination of soil with human faeces Proper sanitary disposal of human faeces Inspection of beef for cysticerci Refrigeration of beef for > 24 hours in deep freeze Thoroughly cooking of beef DIAGNOSIS Gravid proglottid in stool. Count number of main lateral arm of uterus Perianal swabbing with cellophane tape for ova TREATMENT Praziquantel,

beef tapeworm infection taeniasis Diarrhea Abdominal cramps Acute intestinal obstruction due to tangled worms Appendicitis due to gravid proglottid lodging into appendix Inflammation of mucosa due to attachment of scolex Nausea, headache, alteration of appetite. These symptoms may be due to toxic products of worms or are allergic reactions

Scolex: 4 prominent round suckers. No rostellum or hooks present Neck: immature proglottids Mature Proglottids: full set of functioning male & female reproductive organs.Follicular testes scattered ant.-dorsal part of proglottid.Genital pore situated irregularly on alternate lateral margins

Gravid segment: large numbers of branched lateral arms of uterus (15-30)

Taenia Solium (Pig tapeworm) (Cysticercus cellulosae) mucosa of jejunum

EGG

INTERMEDIATE HOST Pig & man (larval stage -Cysticercus cellulosae) MOT

Taeniasis pork-tapeworm infection SAME AS TAENIA SAGITA

round in shape & bile stained. Has a thin egg shell. The radially striated embryophore made of keratin surrounds the hexacanth embryo or oncosphere with 3 pairs of hooklets. Cysticercus cellulosae

eaten raw or undercooked pork

PREVENTION Treat infected individuals Prevent contamination of soil with human faeces Proper sanitary disposal of human faeces

opaque invaginated protoscolex with 4 suckers & 2 rows of hooks inside a fluid filled bladder (cyst)

Inspection of pork for cysticerci Refrigeration of beef for > 24 hours in deep freeze Thoroughly cooking of pork

Cysticercus cellulosae Cyst in brain cerebral cysticercosis causes tumour,meningitis, encephalitis, hydrocephalus. In eyes can cause blurring of vision, atrophy of retina, intraorbital pain & loss of vision Spinal cord may cause nervous manifestations -epilepsy/ convulsion/ headache

CESTODE

MORPHOLOGY

MOT PREVENTION DIAGNOSIS TREATMENT

CLINICAL COMPLICATION

Continue..

ADULT

Scolex: 4 suckers, with double row of alternating large & small hooklets numbering from 22-32 Rostellum present Mature segment: roughly square in shape (12 x 10 mm) almost identical to Taenia saginata

DIAGNOSIS Stool examination Scotch- tape method Examine gravid segment (proglottid) injected with Indian ink & look for the uterine branches TREATMENT Praziquantel,

Gravid segment: Has 7-13 main uterine

Hymenolepis Nana (dwarf tapeworm) (cerocystis or cysticercoid larva or the infective eggs) Small intestine

EGG

INTERMEDIATE HOST Fleas & beetles MOT swallowing the infective intermediate host containing cerocystis or cysticercoid larva or the infective eggs PREVENTION Treat infected individuals Prevent contamination of soil with human faeces Proper sanitary disposal of human faeces DIAGNOSIS stool examination for eggs TREATMENT Praziquantel,

Enteritis abdominal disturbances, loss of appetite, anorexia, vomiting, periodic diarrhoea & dizziness, restless, irritable Pruritus of nose & anus

oval or globular has two membrane enclosing a hexacanth embryo with 6 hooklets. Inner membrane has 2 polar thickenings from each arise 4-8 slender polar filaments Cysticercoid larva

No cyst wall and no bladder filled cavity Solid with invaginated protoscolex

ADULT

Scolex: has 4 suckers with a retractile rostellum with a single row of hooks

Mature proglottids: 4 times as broad as long, with a single genital pore on its left side, three round testes &bilobed ovary

Gravid segment: uterus, sac like contains 80-180 eggs

CESTODE

MORPHOLOGY

MOT PREVENTION DIAGNOSIS TREATMENT

Fleas, beetles & cockroach

CLINICAL COMPLICATION

Hymenolepis Diminuta (rat tapeworm) (cerocystis or cysticercoid larva or the infective eggs) Small intestine

EGG

INTERMEDIATE HOST

No polar thickening and no filament Hexacanth embryo (oncospheres) contains six hooks

MOT swallowing the infective intermediate host containing cerocystis or cysticercoid larva or the infective eggs PREVENTION Treat infected individuals Prevent contamination of soil with human faeces Proper sanitary disposal of human faeces DIAGNOSIS stool examination for eggs TREATMENT Praziquantel,

Hymenolepiasis diarrhoea, loss of appetite mild digestive upset, pain in the stomach/ nervous disorder due to absorption of worms metabolites

Cysticercoid larva

No cyst wall and no bladder filled cavity Solid with invaginated protoscolex

ADULT

Scolex: club shaped has a rudimentary unarmed rostellum without hooks & 4 small suckers

Mature proglottids: 4 times as broad as long, with a single genital pore on its left side, three round testes &bilobed ovary

Diphyllobothrium Latum (plerocercoid larva) small intestine especially in ileum & jejunum

Gravid segment: contains sacular uterus filled with eggs EGG

INTERMEDIATE HOST

Golden brown in colour Inconspicuous operculum on one end & a small knob like thickening at the other end Ovum is unsegmented when passed out

1st intermediate host: Copepod (Cyclops) harbour procercoid larva 2nd intermediate host: fresh water fish harbour plerocercoid larva/ spargana

ADULT

MOT is ingested by the 2nd intermediate host which is a fresh water fish PREVENTION avoid eating raw or improperly cooked fish

Scolex: almond shape with two deep dorsoventral sucking grooves called bothrium Mature segments: are broader than long. The dark rosette coiled uterus in the middle of mature proglottids are characteristic.

DIAGNOSIS stool examination for eggs/gravid segments TREATMENT Praziquantel,

Diphyllobothriasis Bothriocephaliasis fish tapeworm infection broad tapeworm infection Intestinal obstruction (bolus) due to its length or presence of several adult worms Digestive symptoms such as hunger pain, epigastric fullness/ loss of appetite/ anorexia/nausea/vomiting Symptoms are attributed to absorption of toxic secretions or byproducts of the worm/ irritation caused by the worm Causes pernicious hypochromic type of anaemia because the worm competes for Vitamin B12 that is also ingested by the worm .

CESTODE

MORPHOLOGY

MOT PREVENTION DIAGNOSIS TREATMENT TISSUE CESTODES

INTERMEDIATE HOST Man DEFINITIVE HOST: Dogs, wolves

CLINICAL COMPLICATION

Echinococcus Granulosus (egg) small intestine of dogs

EGG

round in shape & bile stained. Has a thin egg shell. The radially striated embryophore made of keratin surrounds the hexacanth embryo or oncosphere with 3 pairs of hooklets. Hydatid cyst ( in mucosa + blood stream )

MOT Eggs passed out are immediately infective to the intermediate host DIAGNOSIS X-ray, Ct scan, Ultrasonography Serology: IFA, ELISA, IHA Casoni test: 0.2 ml of fresh hydatid fluid is injected, if positive a wheal develops about 5 mm within hr. Compare with saline Examine sputum for protoscolices/ hooks

containd 2 litres of fluid Hydatid sand ( in organ + tissues)

Slow growth of cyst increases pressure on the surrounding tissues which resembles a tumour 66% in liver 22% in lungs 3% in kidneys 2% in bones (osseous hydatid cyst) 15% in brain 65 in other tissues/organs (eye, heart, spleen, muscles) Incubation period is about 5 years except in brain and the orbit Anaphylactic shock if cyst is damaged & there is a leakage

ADULT

TREATMENT Membendazole Albendazole

Scolex: with 4 suckers. Non Retractable rostellum with two rows of hooks Proglottids: 3-5 segments (usually 3)

1st segment is immature 2nd segment is mature segment, 3rd segment is gravid segment